Prevalence Of Hyponatremia In Hospitalized Adults And Its Predictive Value On Selected Clinical Outcomes

Objective:Hyponatremia is the most common electrolyte abnormality in clinical practice.It is a risk factor in mortality rate in many cardiac and pulmonary disease,and the proper correction of hyponatremia improves the prognosis.Our research collects the clinical data such as the blood sodium of hospitalized patients through the electronic and paper medical records for statistics and analysis.Hyponatremia database will be established to further analyze the prevalence of hyponatremia and significance on the prognosis of mortality,length of hospital stay,cost,day-cost and other clinical outcomes.Methods:We performed a retrospective study of adults aged ?18 years,excluding those who had no serum sodium values 24 hours within admission and had hyperglycemia during hospitalization.Demographics data(gender and age etc),serum sodium value(at admission,lowest and at discharge),discharge diagnosis and ICD-10 Code were recorded,clinical endpoint were clinical outcome(death or unrecovered),cost and length of hospital stay,comparative differences were obtained between hyponatremia and normal serum sodium groups,unadjusted and adjusted Cox proportional hazards regression was performed to find the association of hyponatremia with all-cause mortality.Groups were compared between aged hyponatremia and normal serum sodium patients,and also between community acquired hyponatremia and hospital acquired hyponatremia.Hyponatremia patients were matched to normal serum sodium patients 1:1 using Propensity score matching and the bad clinical outcomes were compared.Result:A total of 41949 patients were included in this study,4547 patients were hyponatremic,indicating the incidence of hyponatremia as 10.8%,at admission hyponatremia prevalence was 4.8%.Compared hyponatremia patients with normal serum sodium patients,there were more men,older,and a higher Charlson comorbidity score(P<0.001).The incidence of complications compared between hyponatremia patients and normal serum sodium patients were statistically significant(P<0.001).The prevalence of poor prognosis in patients with hyponatremia(hospital outcome as unrecovered or dead)(33.0%VS28.3%,P<0.001),and the mortality(2.0%VS0.1%,P<0.001),were significantly higher than patients with normal serum sodium.The total cost and average daily cost of patients with hyponatremia is significantly higher than patients with normal serum sodium(P<0.001).After the analysis with correction of logistic regression equation?multivariate Cox proportional hazards model analysis and propensity score matching,hyponatremia is still a risk factor for hospital mortality.Conclusion:Hyponatremia is a common clinical electrolyte disorder,and have certain predictive value in the length of hospital stay,cost,mortality,poor prognosis.More attention should be aroused to clinical practice.